1770126781 NPI number — NEUROLOGY PARTNERS PROFESSIONAL CORPORATION

Table of content: BEATRIZ ISABEL LAVELL MD (NPI 1407897705)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770126781 NPI number — NEUROLOGY PARTNERS PROFESSIONAL CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEUROLOGY PARTNERS PROFESSIONAL CORPORATION
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
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Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1770126781
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/03/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1201 E SCHUSTER AVE STE 1A
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EL PASO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
79902-4646
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
915-229-6448
Provider Business Mailing Address Fax Number:
915-600-2113

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1201 E SCHUSTER AVE STE 1A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EL PASO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79902-4646
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
915-229-6448
Provider Business Practice Location Address Fax Number:
915-600-2113
Provider Enumeration Date:
10/22/2019

Additional Information

Authorized Official

Authorized Official Last Name:
EZE
Authorized Official First Name:
CHIGOLUM
Authorized Official Middle Name:
CHIDINMA
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
414-745-0248

Provider Taxonomy Codes

  • Taxonomy code: 2084N0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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